Neonatal-Perinatal Medicine (NPM) Fellowship

About the Fellowship

The SUNY Health Science Center at Brooklyn, Neonatal-Perinatal Medicine Fellowship
program trains and prepares outstanding, compassionate newborn specialists by providing
a comprehensive, strong background in clinical neonatology, requisite skills, physiology,
pathophysiology, pharmacology, and evidence-based neonatal and perinatal practices
and interventions. As well, our fellows are exposed to a scholarly experience of the
highest quality. We are intensely dedicated to advancing, exploring and developing
innovative biomedical, translational, and clinical research. The fellows achieve their
goals through the nurturing and stimulation of basic/clinical scientists, clinicians,
and educators throughout the University and its teaching institutions. The program
offers three new fellowship positions each year and provides a rich and diverse professional
experience that allows appropriate career development and choices. Through our interactive,
collaborative and integrated research, education, and community outreach programs
we are committed to maintaining the highest standards of academic medicine and patient
care.

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SUNY NPM fellowship program includes the perinatal and neonatal services of the State
University of New York Downstate Medical Center University Hospital of Brooklyn (UHB)
and the Kings County Hospital Center (KCHC), with about 4,000 annual combined deliveries.
Each hospital has a 30-bed, Level III-B Neonatal Intensive Care Unit (NICU), which
are located across the street from each other. Both hospitals have a wide perinatal
referral area, with active transfers of critically ill newborns from local Level I
and II nurseries. Our patients are ethnically diverse, mostly from the underserved
population of Brooklyn. In addition to the rich, evidence-based, clinical experience
in neonatal resuscitation and ICU management of sick neonates, we have exposure to
a variety of neonatal surgical conditions with in-house Pediatric surgery. SUNY Downstate
NPM fellowship program will be enriched and strengthened further by the inclusion
of Maimonides Medical Center and its strong neonatal faculty in July 2018. Maimonides
has annual deliveries of more than 9,500 newborns, of which more than 1,000 are admitted
to their Level III-B NICU.

SUNY Downstate Medical Center has been designated and funded by the New York State
Department of Health as the Regional Perinatal Center for North/North Central Brooklyn.
We were the first institution in Brooklyn to implement the Statewide Perinatal Data
System (SPDS) which provides public health and health care professionals around the
state with timely and accurate data about birth outcomes. This data system assists
hospitals in their quality assurance and quality improvement activities. Our program
also leads the Brooklyn-Queens Neonatal Network and coordinates joint educational
and research programs for all NICUs in Brooklyn, Queens and Staten Island.

The NIH funded Neonatal-Perinatal Translational Pharmacology Research Laboratories
are located at the SUNY Downstate Medical Center. Fellows get their translational
research experience and training at this facility, and each fellow is involved in
mentored research training, which results in a peer-reviewed publication. We have
a wide range of bench, clinical and translational research opportunities, including
fetal and neonatal pharmacology and therapeutics, molecular and clinical pharmacology
of Retinopathy of Prematurity, Necrotizing Enterocolitis, Bronchopulmonary Dysplasia
and any other area of interest our fellows may wish to pursue. We collaborate with
various laboratories in the Department of Pediatrics and other Universities, and all
fellows are encouraged to participate in these initiatives. All fellows are actively
involved in Quality Improvement projects and are members of various inter-disciplinary
committees in the hospital.

NICU clinical service rotations are divided evenly between UHB and KCHC, and soon
with Maimonides Hospital. Both UHB and KCHC units are covered by one on-call fellow
at night and on weekends. The first year will include 7 months of NICU service rotations,
4 months of research and 1 month of vacation. The second year will include 5 months
of NICU service rotations, including 1 month at the Neonatal Cardiac ICU service at
Columbia University New York Presbyterian- Morgan Stanley Children's Hospital, 6 months
of research and 1 month of vacation. The third year will include 3 months of NICU
service, 7 months of research, 1 month of Maternal-Fetal Medicine at Maimonides Hospital
Center in Brooklyn, and 1 month of vacation.

Overall, the 3 year training period consists of 16 months of Clinical Rotations (including
14 months of NICU experience, 1 month of Neonatal Cardiac ICU and 1 month of Maternal-
Fetal Medicine); 17 months of research and scholarly activities and 3 months of vacation
(one month per year). First year fellows are on call 7 times a month, second year
fellows 6 times a month and third year fellows 5 times a month. While on their research
rotations, the fellows also participate in High Risk clinic on Friday mornings, 3-4
times a month at KCHC and Neurodevelopmental Clinic at UHB, including the Early Intervention
Programs of the SUNY-Department of Pediatrics and other Universities.

NIH/NICHD: 1U54HD071594-01 (Aranda JV- PI) 09/01/2011 to 08/31/2016 $ 3.69 million,
No cost ext. = 06/30/2018 TITLE: Molecular and Clinical Pharmacology of Retinopathy
of Prematurity – The goals of this project are to establish a specialized center in
research in pediatric developmental pharmacology to study the molecular and clinical
pharmacology of ROP (Role: PI) No overlap

NIH/NICHD: 1R03 HD057566-01 (Aranda JV- PI) 01/01/2008 to 12/31/2010 (No cost extension
to 08/31/2012 ($ 193,175.00) Absorption and Metabolism of Oral Codeine in Mechanically
Ventilated Neonates The goal of this study is to determine the absorption and metabolism of codeine and
the pharmacogenomics, pharmacokinetic, pharmacodynamics characteristics of this drug
in preterm newborns. 2.4 months Role: PI (No Overlap)

NIH/NICHD: 5-U01HD-37261-01 ( Aranda JV: PI then Co-I) 01/01/2004 to 12/31/2008 extended
to 12/31/2012 ($1,984,324.00) Title: Children's Center for Clinical Pharmacology Research-Pediatric
Pharmacology Research Unit Network (PPRU) The goal of the PPRU Network is to develop
and conduct translational and clinical trials in newborns and children. (No overlap)
3.6 months as PI ( 1/1/2004 to 11/1/2007 then 2.4 months ( 11/1/2007 to 12/31/2010)
Role of PI changed due to move to New York

Interests/Specialties/Grants: Molecular and clinical pharmacology of Retinopathy of Prematurity; Molecular signaling
in angiogenesis in human endothelial cell cultures, Intermittent hypoxia and hyperoxia
in oxygen induced retinopathy in the neonatal rat model, NSAIDs for the newborn, Caffeine
and NSAIDs for Retinopathy.

NIH/NICHD: 1U54HD071594-01 (Aranda JV- PI) 09/01/2011 to 08/31/2016 $ 3.69 million,
No cost ext. = 06/30/2018 TITLE: Molecular and Clinical Pharmacology of Retinopathy
of Prematurity – The goals of this project are to establish a specialized center in
research in pediatric developmental pharmacology to study the molecular and clinical
pharmacology of ROP (Role: Core Director and Co -PI) No overlap

Interests/Specialties: Role of prebiotics, probiotics and synbiotics in neonatal necrotizing enterocolitis;
Mediators of inflammation, toll like receptors in neonatal necrotizing enterocolitis; Allergic enterocolitis in neonates.

Research interests: Sara is currently exploring the effects of Ibuprofen, Caffeine and intermittent
hypoxia on a neonatal rat model of Acute Kidney Injury (AKI). Clinical interests include
AKI in preterm infants and she is involved with an Enteral nutrition quality improvement
project at UHB NICU.

Research Interests: Michael is currently involved in our research lab exploring the role of Paneth Cells
in a rat model of Necrotizing Enterocolitis and varying degrees of intermittent hypoxia.
His clinical interests include the use of Acetaminophen in preterm infants. As well,
he is involved in a multi-disciplinary Quality Improvement project involving early
enteral feeding in preterm infants and a standardized feeding protocol to improve
discharge weights.

Research Interests: Jacqueline is currently involved in our research lab exploring the role of Toll-Like
Receptor signaling molecules and antioxidants in a rat model of Necrotizing Enterocolitis
and varying degrees of intermittent hypoxia. She is also involved in a multi-disciplinary
Quality Improvement project involving early enteral feeding in preterm infants and
a standardized feeding protocol to improve discharge weights.

Research Interests: Sibel is currently pursuing research activities on the role of Aquaporins in the
pathogenesis of retinopathy of prematurity and how this may be used for targeting
pharmacologic interventions to prevent ROP in the future. She also has special interest
in evaluation and management for early onset sepsis.

Research Interests: Michelle's translational research includes elucidating the role of oxidative stress
and the use of antioxidants in the prevention of retinopathy of prematurity (ROP)
using the neonatal rat model of oxygen-induced retinopathy developed by Beharry et
al. Her clinical research includes determining the effect of interventional services
compared to only standard medical follow-up of preterm and high-risk late preterm/term
infants at preschool age and school age. She is comparing preschool age and school
age speech, neurocognitive and motor outcomes of preterm and high-risk late preterm/term
infants who receive early intervention up to 3 years of age. She also aims to educate
and facilitate NICU mothers about early expression of colostrum to improve breast
feeding compliance until discharge.

Research interests: Pumi is researching the effects of high dose caffeine on neuronal damage from exposure
to hyperoxia and intermittent hyperoxia-hypoxia in a rat model of extremely premature
neonates. She has used a special Golgi-Cox silver which is able to stain dendrites
specifically. The results have shown adverse effects of high-dose caffeine and severe
damage to the dendrites from continuous hyperoxia; publication is in process. Pumi
also researched feeding practices at Kings County Hospital and its relation to the
development of NEC.

Recent Graduates

2017

Position

Michelle Quan, MD MD: SUNY Stony Brook

Clinical Assistant Professor and Attending Neonatologist, New York University Langone
Medical Center, NY

In principle, the SUNY NPM Fellowship program invites and accepts applications from
those who have completed or are in the process of completing an ACGME or Royal College
of Physicians (Canada) approved three year residency in Pediatrics. SUNY Downstate
participates in the National Residency Matching Program and accesses applications
from ERAS. (ACGME ID 3263521022).